边永钎 李跃军 李靖 李金清 李学拥

[摘要]目的：探讨案例教学法（Care based learning，CBL）结合微课双轨教学在烧伤外科临床教学中的效果。方法：研究对象为在笔者医院烧伤外科实习的65名临床本科学员，其中实验组33名学员接受CBL与微课相结合的双轨式教学，对照组32名学员接受CBL教学。实习结束后，利用理论考试、实践操作和调查问卷方式评估教学效果。结果：教学后，实验组笔试成绩、操作成绩和总成绩均明显高于对照组，且激发学员学习兴趣、促进知识理解和掌握方面评分明显高于对照组，差异有统计学意义（P<0.05）。结论：CBL结合微课双轨教学在烧伤外科临床教学中效果明显，值得临床教学中推广应用。

[关键词]烧伤外科;临床教学;案例教学法;微课;双轨教学

[中图分类号]G642    [文献标志码]A    [文章编号]1008-6455（2020）07-0148-03

Abstract： Objective  To explore the effect of CBL combined with micro-course dual-track teaching mode in the clinical practice teaching of burn surgery. Methods  A total of 65 undergraduate students were enrolled in the study and randomly divided into the research group （n=33） and the control group （n=32）. Students in the research group were subjected to the CBL combined with micro-course dual-track teaching mode and the control group to the CBL mode. The effects were evaluated by the examination and questionnaire survey at the end of clinical practice. Results  After teaching， the experimental group's written test scores， operation scores and total scores were significantly higher than those of the control group， and the scores in stimulating students' learning interest， promoting knowledge understanding and mastery were significantly higher than those in the control group， the differences were statistically significant （P<0.05）. Conclusion  CBL combined with micro-course dual-track teaching mode has a significant effect in the clinical teaching practice of burn surgery， which is worthy more promotion.

Key words： burn surgery; clinical teaching; case teaching method; micro-lecture; dual-track teaching

燒伤是指理化因素导致的皮肤、皮下甚至深层组织的损伤，其具有灾难医学和急症医学的特征，几乎涵盖所有外科学理论知识，并与多数临床学科相交叉，救治过程中常需协同内、外科多个科室[1]。另外，由于早期创伤后应激综合征以及后期整形美容等需求，烧伤医生除了具备过硬的专科素质外还需具备一定的心理学知识。但在本科生烧伤外科临床教学中却存在课时不足、内容繁杂、教学模式相对枯燥、典型病例难以获得、序贯性治疗难以跟进等问题[2-3]。因此，寻找适合烧伤外科实习的教学模式，使学生在有限时间获得大量专业知识并灵活应用到临床实践，以培养和提高其综合素养就显得极为重要。

案例教学法（Case based learning，CBL）是“以案例为基础，以问题为索引，以学生为主体，以临床思路为主线”的教学模式，旨在通过整合和互动手段帮助学生建立临床思路，提高其解决临床问题能力[4]。……